Doctors To Face Appraisals Each Year To Check They Are Fit To Practice

Doctors' skills are to be reassessed every year to ensure they are fit to practise, Health Secretary Jeremy Hunt has announced, in what has been dubbed the "biggest change in medical regulation for 150 years".

At present, doctors can go for their entire career without facing any formal assessment of their competency.

But from December this year, doctors will be assessed to see if they are fit to stay on the medical register, Mr Hunt said.

The General Medical Council (GMC) said the move was the biggest shake-up in a century and a half, and will mean that problems with doctors are flagged earlier.

The assessment will take the form of an annual appraisal and a more comprehensive meeting every five years, when licences will be renewed.

Health officials have been considering revalidation for many years.

The move towards 'medical MOTs' has its roots in the 2001 public inquiry into failings in the children's heart surgery service at Bristol Royal Infirmary.

But the 2005 Shipman Inquiry, which looked into the case of serial killer and GP Harold Shipman, was heavily critical of the initial proposals so health officials created a new model and organised pilots.

Doctors will be expected to demonstrate they meet clinical standards and have kept up to speed with the latest developments in their field. Appraisals will include feedback from patients and colleagues.

Hunt said: "We want to have the best survival rates in Europe for the major killer diseases.

"Doctors save lives every day and making sure they are up to speed with the latest treatments and technologies will help them save even more. This is why a proper system of revalidation is so important."

In one pilot study, conducted on 3,000 doctors, concerns were raised about 1% of the medics.

Another survey of 320 of the designated bodies in England found concerns about 4.1% of doctors.

Worries raised ranged from tardiness to more serious concerns about clinical competency.

Niall Dickson, chief executive of the GMC, said: "This is an historic moment, it is the biggest change in medical regulation for more than 150 years.

"The decision to press ahead with revalidation after many years of preparation and planning means that we'll be able to have a comprehensive system of regular checks for all doctors registered in the UK.

"Every NHS doctor is already supposed to have an annual appraisal but until revalidation appeared on the horizon many organisations were simply not achieving this.

Now both the NHS and private healthcare organisations have begun to get their act together.

"Revalidation is not a panacea, it is not a magic bullet to guarantee that care is safe or that every doctor is perfect, it will take time to settle in, we will need to evaluate and improve the model."

NHS medical director Professor Sir Bruce Keogh admitted that implementation will be "initially quite difficult" and that the system would not be immediately perfect, but added: "My personal view is that it is better to start than wait for perfection."

He added: "I think that every doctor has a duty to be able to describe what they do and to define how well they do it - if you can't do that you forfeit some of your professionalism.

"The process of assessing doctors in this new revalidation process is based on a beefed up appraisal system within the NHS."

The process will start in December with the revalidation of medical leaders and from April next year it will start to assess mainstream doctors.

By April next year every doctor will have been told when their revalidation is due. By 2014, 20% will have been revalidated and the "vast majority" will have been through the process by April 2016.

Dr Mark Porter, chair of council at the British Medical Association (BMA), said: "The BMA has always supported the principle of revalidation - we believe it is important that our patients have confidence that doctors have up-to-date skills and knowledge to be able to offer them the best possible care.

"It is important to recognise that while revalidation will undoubtedly enhance the rigorous testing that doctors undergo, clinicians are already offering patients a very high quality service, and robust systems are currently in place to deal with any concerns.

"There is too much bureaucracy in the NHS and so we have to be careful that revalidation does not add to this unnecessarily.

"The system soon to be rolled out is much better to the one initially put forward. But we still need to ensure consistency across the UK so that all doctors are working to the same standards.

"It is essential that revalidation is reviewed every step of the way so that we can be sure that the system works for patients and for doctors."